Ze-Hua Zhao, Yu-Chen Fan, Yang Yang, Kai Wang, Department of Hepatology, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China.
World J Gastroenterol. 2013 Nov 7;19(41):7189-96. doi: 10.3748/wjg.v19.i41.7189.
To assess diagnostic accuracy of Ras association domain family 1A (RASSF1A) promoter methylation in body fluids (serum, plasma and whole blood) for hepatocellular carcinoma (HCC).
Relative information about study characteristics and incidence of RASSF1A methylation was collected. Quality of all included studies was evaluated by Quality Assessment of Diagnostic Accuracy Studies-2. Sensitivity and specificity were pooled using a random-effect model, and a summary receiver operating characteristic curve was used to demonstrate the overall diagnostic performance. Positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) with 95%CI were also calculated. Meta-regression was applied to analyze observed heterogeneity, and Deeks' test was performed to detect publication bias.
After a systematic literature review, seven studies with a total of 302 cases of HCC and 250 cases of chronic liver diseases were included in the analysis. The pooled sensitivity and specificity were 0.70 (95%CI: 0.49-0.85) and 0.72 (95%CI: 0.54-0.85), respectively. The PLR was 2.51 (95%CI: 1.64-3.86), NLR was 0.41 (95%CI: 0.25-0.68), and DOR was 6.13 (95%CI: 3.17-11.84). The χ(2) values of sensitivity, specificity, PLR, NLR and DOR were 59.41 (P < 0.001), 50.50 (P < 0.001), 17.40 (P = 0.010), 31.24 (P < 0.001) and 80.51 (P < 0.001), respectively. The area under the curve was 0.77 (95%CI: 0.73-0.81). Three factors were analyzed by univariate meta-regression and none was significant to interpret the observed heterogeneity (P > 0.05). No significant publication bias was detected by Deeks' test (P = 0.346).
We showed the potential diagnostic value of RASSF1A methylation in body fluids in HCC patients and it may improve diagnostic accuracy combined with the α-fetoprotein test.
评估 Ras 相关结构域家族 1A（RASSF1A）启动子甲基化在体液（血清、血浆和全血）中用于肝细胞癌（HCC）的诊断准确性。
收集了有关研究特征和 RASSF1A 甲基化发生率的相对信息。使用 Quality Assessment of Diagnostic Accuracy Studies-2 评估所有纳入研究的质量。使用随机效应模型汇总灵敏度和特异性，并使用综合受试者工作特征曲线显示总体诊断性能。还计算了阳性似然比（PLR）、阴性似然比（NLR）和诊断优势比（DOR）及其 95%CI。应用 Meta 回归分析观察到的异质性，并进行 Deeks 检验以检测发表偏倚。
经过系统文献回顾，纳入了 7 项研究，共 302 例 HCC 病例和 250 例慢性肝病病例。汇总的灵敏度和特异性分别为 0.70（95%CI：0.49-0.85）和 0.72（95%CI：0.54-0.85）。PLR 为 2.51（95%CI：1.64-3.86），NLR 为 0.41（95%CI：0.25-0.68），DOR 为 6.13（95%CI：3.17-11.84）。灵敏度、特异性、PLR、NLR 和 DOR 的 χ² 值分别为 59.41（P < 0.001）、50.50（P < 0.001）、17.40（P = 0.010）、31.24（P < 0.001）和 80.51（P < 0.001）。曲线下面积为 0.77（95%CI：0.73-0.81）。单变量 Meta 回归分析了 3 个因素，均无显著意义来解释观察到的异质性（P > 0.05）。Deeks 检验未检测到显著的发表偏倚（P = 0.346）。
我们表明 RASSF1A 甲基化在 HCC 患者体液中具有潜在的诊断价值，与甲胎蛋白检测相结合可能会提高诊断准确性。
